Childhood trauma as a risk factor for psychosis: A sib-pair study
Section snippets
Background
Childhood trauma has been proposed to have a causal role in adult mental health disorders (Spataro et al., 2004), including psychosis. Since the publication of three population studies in 2004 (Bebbington et al., 2004, Janssen et al., 2004, Spataro et al., 2004), an interest in childhood trauma as a risk factor for psychosis development has grown. In two recent meta-analyses (Varese et al., 2012, Matheson et al., 2013), childhood adversity and trauma were found to be associated with an
Participants
This is a 1:1 matched study that included 60 adult patients who were individually paired with a non-psychotic sibling. The patients satisfied the following three inclusion criteria: 1) having a functional psychosis according to DSM-IV psychotic codes 295–298 (American Psychiatric Association, 2000); 2) having less than 5 years of illness; and 3) having a sibling free of psychotic symptoms who was willing to participate in the study. Patients were recruited in the mental health inpatient
Sample characteristics
The diagnoses of the 60 patients whose siblings provided written informed consent and were free of psychotic symptoms were: schizophrenia [58.3% (35/60)]; schizophreniform disorder [1.7% (1/60)]; brief psychotic disorder [15% (9/60)]; schizoaffective disorder [5% (3/60)]; and depressive or manic episode with psychotic features [20% (12/60)].
Comparisons of dichotomous and continuous variables between patients (n = 60) and siblings (n = 60) are described in Table 1, Table 2, respectively.
Discussion
The main result of our study is that both childhood trauma and cannabis use were significantly associated with an increased risk of developing functional psychosis. However, this matched study did not find evidence of a significant synergistic interaction between childhood trauma and cannabis use: these two factors independently increased the risk of developing psychosis in our population. Moreover, a neurotic personality also contributed independently to this risk.
The principal strength of our
Role of funding source
The funding sources did not participate in the collection of data, the interpretation of the results or the writing of the manuscript. They have not taken part in the decision of submitting the manuscript for publication.
This work was partially supported by Grant GI8374199 (Ayudas económicas para el desarrollo de proyectos de investigación sobre drogodependencias 2007, BOE 263, 2 November 2007), BAE 09/90088, Estancia Formativa de la Junta de Andalucia 2010, and grant PI-0211-2007 of
Conflict of interest
None.
Contributors
María L. Barrigón participated in the design of the study, the collection of data, the interpretation of the data and the drafting the article; she approved the final version of the manuscript. Francisco J. Diaz conducted the statistical analyses and participated in the interpretation of the data and the drafting the article; he approved the final version of the manuscript. Manuel Gurpegui participated in the design of the study, the interpretation of the data and in drafting the article; he
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